FAQ

Although it would be easier to offer a simple answer to such a question, research indicates that the causes of same-sex attraction and a homosexual orientation are complex, influenced by a variety of contributing factors. Some of the factors that have been studied and considered include biological, socio-cultural, interpersonal and environment influences. Biological antecedents include the prenatal hormonal hypothesis (e.g., Swaab & Hofman, 1990; Allen & Gorski, 1992; LeVay, 1991) and the genetic hypothesis (Bailey, 1996; Bailey & Pillard, 1991; Bearman & Brückner, 2002; Dean Hamer et al., 1993). Interpersonal experiences include the psychoanalytic theory of parent-child relationships (i.e. overbearing mother, distant or critical father; Bieber et al., 1962; Evans, 1969), elevated rates of childhood sexual abuse (Lauman et al., 1994), and feeling different for gender-related reasons (e.g., Bem, 1996). Environment factors include peer group relationships, same-sex experimentation including early sexual debut (D’Augelli and Hershberger, 1993; McWhirter and Mattison, 1984), family relationships (Stacey & Biblarz, 2001) and religious valuative frameworks, at least insofar as personal and faith-based beliefs and values influence sexual behavior and identity (Yarhouse & Tan, 2004). Further complicating the answer to this question is research suggesting that attractions change over time in both direction (toward the opposite- or same-sex) and intensity (Diamond, 2008; 2000; Jones & Yarhouse, 2007; Spitzer, 2003; Rosario, Schrimshaw, Hunter & Braun, 2006).

It is thought that each of these elements can contribute to, but that no one cause is fully responsible for, the development of same-sex attraction.

We have found it helpful in these discussions to make a “three-tier” distinction between same-sex attraction, a homosexual orientation, and a gay identity.

What do you mean by a “three-tier” distinction?

Some people may find it helpful to distinguish between same-sex attraction, a homosexual orientation, and a gay identity.

Same-sex attraction: this is the most descriptive way people can discuss their experiences. They have feelings of attraction toward members of the same sex. In Laumann et al.’s (1994) study, 6.2% of men and 4.2% of women reported experiencing same-sex attraction.

Sexual orientation: refers to the direction and persistence of one’s experiences of sexual attraction toward the opposite sex, same sex, or both (Crooks and Baur, 2002; Yarhouse and Burkett, 2003). Again, in the Laumann et al. (1994) study, 2.0% of men and 0.9% of women reported a homosexual orientation.

Gay identity: this is a sociocultural label that helps people communicate to others something about their sexual preferences (e.g., “gay”, “straight”, and “bi”). It may be based upon a person’s sense of his or her biological sex (as male or female), gender identity (as masculine or feminine), direction and persistence of sexual attractions (sexual orientation), intentions and behaviors (what one intends and chooses to do with the attractions one experiences), and beliefs and values about sexual behavior.

So a person may experience same-sex attraction, and that person may experience sufficient same-sex attraction so that they can say of themselves, “I have a homosexual orientation.” By this they may mean that the attractions to the same sex are rather durable and persistent. The person may also decide to integrate these experiences of attraction into a gay identity, to take on the self-defining attribution, “I am gay.” Others may dis-identify with their experiences of same-sex attraction or they may choose to dis-identify with a gay identity and the persons and organizations who support such an identity (Yarhouse & Tan, 2004). For more information on the three-tier distinction, see Yarhouse, M.A. (2005), Same-sex attraction, homosexual orientation, and gay identity: A three-tier distinction for counseling and pastoral care. Journal of Pastoral Care & Counseling, Vol. 59 (no. 3), 201-212.

How can someone receive help?

This depends on the individual and his/her goals. Because each person is seeking help for various reasons, there are a variety of services available to individuals experiencing same-sex attraction. These options fall along a continuum of services.

These terms are often thought to be synonymous, but reorientation or conversion therapy is a broader umbrella term for a number of treatment approaches that attempt to decrease or eliminate same-sex attraction and increase attraction to the opposite-sex. Reparative therapy is a specific type of reorientation therapy that addresses what adherents of this therapy see as a normal, healthy drive that has been misdirected often due to disturbances in early parent-child relationships (see Nicolosi, 2000).

For individuals who may find it difficult to change their attractions or orientation, or who may experience some movement away from same-sex attraction but not a subsequent attraction to the opposite-sex, some decide to refrain from acting on same-sex desires (Lundy & Rekers, 1995).

The focus of this approach is less on sexual attraction or even behavior as such, but on an individual’s intentional choice to integrate experiences of same-sex attraction into a gay identity or to dis-identify with one’s sexual attractions and individuals and organizations that support such an identity (McConaghy, 1993).

Individuals who pursue this type of treatment integrate their experiences of same-sex attraction into a gay identity. Most individuals from this philosophy believe that change of orientation is not possible (Dworkin, 2000).

In addition to these professional approaches, there are a number of religiously-affiliated paraprofessional and church-based ministries for persons sorting out sexual identity concerns. Some of these are explicityly gay affirmative/integrative in nature (e.g., the Metropolitan Community Church), while others focus on leaving homosexuality and establishing chastity in relationships and possibly change in sexual orientation (e.g., Exodus, Homosexuals Anonymous).

A study published by Dr. Stanton Jones and Dr. Mark Yarhouse followed participants in Exodus ministries over three years and reported the following categories: Success: Conversion (15% of the sample); Success: Chastity (23%); Continuing (29%); Nonresponse (15%); Failure: Confused (4%); and Failure: Gay Identity (8%). Please note that “failure” was from a ministry perspective in which the ministry was assisting the person in leaving homosexuality and moving toward chastity and is not intended to suggest anything about the persons who made different decisions about their own attractions and behavior.

What is Sexual Identity Therapy?

Sexual identity therapy is most closely associated with the description of sexual identity management mentioned above. Sexual identity therapy provides a place for clients to sort out how they wish to live in light of their beliefs and values. The focus of this approach is to assist clients as they seek congruence – so that their behavior and sexual identity line up with their beliefs and values. There are four phases of this therapy: (1) assessment, (2) advanced or expanded informed consent, (3) psychotherapy, and (4) social integration of a valued sexual identity.

References

Allen, L., & Gorski, R. (1992). Sexual orientation and the size of the anterior commissure in the human brain. Proceedings of the National Academy of Science USA, 89, 7199-7202.

Stall, R., Gagnon, J., Coates, T., Catania, J., & Wiley, J. (1990, August). “Prevalence of Men who have Sex with Men in the United States,” in J. Catania (Chairperson), Results from the First National AIDS Behavioral Survey, Symposium presented at the convention of the American Psychological Association, San Francisco, CA.